Comprehensive geriatric assessment for older adults admitted to ...

More documents

Recommendations

Info

Harris 1991 (Continued) Selective reporting (reporting bias) Unclear risk No a priori documentation could be found to judge this item. Data presented in some cases in graphical form only Other bias High risk Some evidence of attrition bias was evident for functional outcomes, although follow up was complete for outcomes such as death or institutionalisation. Data from functional outcomes were not available for use in analysis. Selection bias unclear with open randomisation. Baseline characteristics appear similar Baseline outcome measurements similar Low risk Demographic and other baseline measurements identical between groups Baseline characteristics similar Low risk No significant differences between groups Study protected against contamination Low risk Care delivered by different staff in separate units Hogan 1987 Methods Year: 1987 Location: Halifax, Canada (Community Hospital) Team/ward?: team Timing: stepdown Trial methodology: randomised controlled trial Participants Numbers (total): 113 Mean age: 82 Male:female ratio: 30% male (approximately) Inclusion criteria: all patients over 75 admitted to Dept of Medicine on an emergency basis, with confusional state, impaired mobility, falls, urinary incontinence, polypharmacy, living in a nursing home or admission within previous 3 months Exclusion criteria: ICU, stroke, permission refused by patient or attending physician Patient selection criteria: selected Patient selection criteria details: screened within 48 hours. Seen by consultation team - geriatrician, nurse and physiotherapist - most within a week of hospitalisation, criteria as above Interventions Team members: senior geriatrician, specialist nurse, physiotherapists Team organisation: comprehensive assessment, at least weekly MDT Outcomes Outcomes: death, institutionalisation, cognitive status, readmissions, length of stay, costs Trial conclusions: improved cognitive status, reduced polypharmacy and reduced shortterm mortality demonstrated Comprehensive geriatric assessment for older adults admitted to hospital (Review) Copyright © 2011 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd. 32
Hogan 1987 (Continued) Notes Risk of bias Bias Authors’ judgement Support for judgement Random sequence generation (selection bias) Low risk Random number generation Allocation concealment (selection bias) High risk Not described. Allocation by assessor not responsible for delivering care. Blinding (performance bias and detection bias) All outcomes Incomplete outcome data (attrition bias) All outcomes Unclear risk Outcome assessment only Low risk Analysis appears to be per protocol Selective reporting (reporting bias) Unclear risk No a priori documentation could be found to judge this item Other bias Unclear risk Evidence of selection bias unclear due to lack of clarity in description of randomisation method Baseline outcome measurements similar Low risk Measurements appear similar Baseline characteristics similar Low risk Slight differences exist in the male:female proportion which may reflect the small sample size Study protected against contamination Unclear risk Four patients in the control group were removed from analysis after a review was requested from the intervention team according to clinical need Kay 1992 Methods Year: 1992 Location: Toronto, Canada (Community Hospital) Team/ward?: ward Timing: stepdown Trial methodology: randomised controlled trial (patients ’randomly assigned’) Participants Numbers (total): 59 Mean age: 81 Male:female ratio: 45% male Comprehensive geriatric assessment for older adults admitted to hospital (Review) Copyright © 2011 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd. 33
Page 1 and 2: Comprehensive geriatric assessment
Page 3 and 4: [Intervention Review] Comprehensive
Page 5 and 6: A third has evaluated the subgroup
Page 7 and 8: AARP Ageline (from 1978 to April 20
Page 9 and 10: Figure 2. Comprehensive geriatric a
Page 11 and 12: esults are only reported where sign
Page 13 and 14: Table 1. Cost analysis Cost Analysi
Page 15 and 16: these subgroups (teams with needs-r
Page 17 and 18: Again, analysis suggested that wher
Page 19 and 20: an acute care hospital. Canadian Me
Page 21 and 22: Liem 1986 {published data only} Lie
Page 23 and 24: C H A R A C T E R I S T I C S O F S
Page 25 and 26: Asplund 2000 (Continued) Random seq
Page 27 and 28: Cohen 2002 GEMC Methods This is the
Page 29 and 30: Cohen 2002 UCOP (Continued) Selecti
Page 31 and 32: Counsell 2000 (Continued) Intervent
Page 33: Fretwell 1990 (Continued) Study pro
Page 37 and 38: Kircher 2007 Methods Year: 2007 Loc
Page 39 and 40: Landefeld 1995 (Continued) Allocati
Page 41 and 42: Naughton 1994 (Continued) Intervent
Page 43 and 44: Nikolaus 1999 plus ESD (Continued)
Page 45 and 46: Powell 1990 (Continued) Random sequ
Page 47 and 48: Rubenstein 1984 Methods Year: 1984
Page 49 and 50: Saltvedt 2002 (Continued) Random se
Page 51 and 52: Thomas 1993 (Continued) Patient sel
Page 53 and 54: White 1994 (Continued) Other bias U
Page 55 and 56: (Continued) Cole 1991 Evaluation of
Page 57 and 58: D A T A A N D A N A L Y S E S Compa
Page 59 and 60: 2.6 Teams (stepdown assessment) Com
Page 61 and 62: Analysis 1.2. Comparison 1 CGA vers
Page 63 and 64: (... Continued) Study or subgroup T
Page 65 and 66: (... Continued) Study or subgroup T
Page 71 and 72: Analysis 1.10. Comparison 1 CGA ver
Page 73 and 74: Analysis 1.12. Comparison 1 CGA ver
Page 77 and 78: (... Continued) Study or subgroup F
Page 79 and 80: (... Continued) Study or subgroup E
Page 81 and 82: (... Continued) Study or subgroup E
Page 85 and 86:
10. *“outcome and process assessm
show all

Comprehensive geriatric assessment for older adults admitted to ...

You also want an ePaper? Increase the reach of your titles

Delete template?

Save as template?